Introduction: Medullary thyroid cancer (MTC) is a rare endocrine tumor, which can be sporadic or familial, as a component of multiple endocrine neoplasia 2 (MEN2). Overall, 10% of MTC cases has already developed at presentation or will develop metastasis during follow-up. Testicular metastases are exceptional and only one case of unilateral testis' involvement by metastatic MTC has been already reported in literature. We described the first known case of asymptomatic bilateral testicular MTC metastases, discovered incidentally at testicular ultrasound performed for unrelated reasons. Case presentation: A Latin-American 32-year-old man with MEN 2A syndrome and metastatic MTC underwent andrological and urological examination due to premature ejaculation. Ultrasound imaging showed two symmetrical hypoecoic lesions involving both testis. Suspecting a bilateral testicular cancer, the patient underwent excision biopsy of both testicular lesions. Histopathology and immunoistochemical exams documented metastatic MTC of both testicular lesions. Conclusion: Beyond its rarity, testis should be considered as potential metastatic site of MTC, especially in patients with advanced disease.
Bilateral testicular metastases of MTC in an adult male with MEN2A syndrome: case report and review of literature
Orsolini, Francesca;Prete, Alessandro;Falcetta, Pierpaolo;Basolo, Fulvio;Alì, Greta;Manassero, Francesca;Vitti, Paolo;Elisei, Rossella;Molinaro, Eleonora
2022-01-01
Abstract
Introduction: Medullary thyroid cancer (MTC) is a rare endocrine tumor, which can be sporadic or familial, as a component of multiple endocrine neoplasia 2 (MEN2). Overall, 10% of MTC cases has already developed at presentation or will develop metastasis during follow-up. Testicular metastases are exceptional and only one case of unilateral testis' involvement by metastatic MTC has been already reported in literature. We described the first known case of asymptomatic bilateral testicular MTC metastases, discovered incidentally at testicular ultrasound performed for unrelated reasons. Case presentation: A Latin-American 32-year-old man with MEN 2A syndrome and metastatic MTC underwent andrological and urological examination due to premature ejaculation. Ultrasound imaging showed two symmetrical hypoecoic lesions involving both testis. Suspecting a bilateral testicular cancer, the patient underwent excision biopsy of both testicular lesions. Histopathology and immunoistochemical exams documented metastatic MTC of both testicular lesions. Conclusion: Beyond its rarity, testis should be considered as potential metastatic site of MTC, especially in patients with advanced disease.I documenti in IRIS sono protetti da copyright e tutti i diritti sono riservati, salvo diversa indicazione.
